Healthcare Provider Details

I. General information

NPI: 1538075742
Provider Name (Legal Business Name): JESSICA GALVAN ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 E RIVER RD
TUCSON AZ
85718-6522
US

IV. Provider business mailing address

10141 E DANBURY PL
TUCSON AZ
85748-6782
US

V. Phone/Fax

Practice location:
  • Phone: 520-795-7750
  • Fax:
Mailing address:
  • Phone: 520-982-5802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN193345
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: